Individual provider Active NPI

Charles Reginald Woods III, M.D.

  • Radiation Oncology Physician
  • Riverdale, GA
National Provider Identifier
1679739825
Registry record updated Dec 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
069673 Issued in GA
Practice address
275 Professional CT
Suite B
Riverdale, GA 30274-2531
Phone
(770) 907-0554
Fax
(770) 907-9048
NPI assigned
Aug 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 069673 GA Primary

Addresses

Primary practice location

275 Professional CT
Suite B
Riverdale, GA 30274-2531

Mailing address

275 Professional CT
Suite B
Riverdale, GA 30274-2531
Phone (770) 907-0554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130715000441 GA Practitioner - Radiation Oncology 6608016613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Medical College of Georgia School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Therapeutic Radiation Oncology, PCGroup PAC ID 2163325812, 8 clinicians

Practice addresses (Care Compare)

1255 Hwy 54 W
Fayetteville, GA 30214-4526
Phone (770) 719-7071

Hospital & facility affiliations

  • Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215
  • Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083
  • Piedmont Newnan Hospital, Inc Hospital, Newnan, GA, CCN 110229
  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Griffin Regional Radiation Therapy Center, Inc. Radiation Oncology Current Accepting new patients
Therapeutic Radiation Oncology, PC Radiation Oncology CurrentSince Jul 20, 2013 Accepting new patients

Locations

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1800 Hospital South Dr
Austell, GA 30106
Phone (770) 793-7196

1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911

725 S 8th St
Griffin, GA 30224
Phone (404) 222-9411

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

275 Professional Ct
#B
Riverdale, GA 30274
Phone (770) 907-0554

275 Professional Ct
#A
Riverdale, GA 30274

255 Professional Ct
Riverdale, GA 30274
Phone (770) 907-0554

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480982400000",
    "number": "1679739825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 PROFESSIONAL CT",
            "address_2": "SUITE B",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742531",
            "telephone_number": "770-907-0554",
            "fax_number": "770-907-9048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 PROFESSIONAL CT",
            "address_2": "SUITE B",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742531",
            "telephone_number": "770-907-0554",
            "fax_number": "770-907-9048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODS",
        "first_name": "CHARLES",
        "middle_name": "REGINALD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-06",
        "last_updated": "2016-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "GA",
            "license": "069673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

Verify at the official NPI Registry.